Most Adults with Arthritis Don’t Walk Enough

Despite the proven benefits for arthritis, many have a hard time getting started.

05/03/2013 | By Jennifer Davis

“When we do focus groups, people say, ‘When I first started it was hard. I got sore and I kind of wanted to stop.’ But then, when they stick with it they get pain relief; they get better function.”

Patience White, MD, vice president for public health policy and advocacy at the Arthritis Foundation, says that while it’s generally understood that people don’t exercise as much as they should this state-by-state breakdown is a serious call to action.

“What they are saying is, ‘Whoa! We have a pretty significant problem in terms of people doing the most simple exercise plan.’ We aren’t asking them to go to a gym or go running. We are just asking them to walk,” says Dr. White, who is also a professor of medicine and pediatrics at George Washington University’s School of Medicine in Washington, D.C. “We’ve got a lot of work to do to let people with arthritis know how good walking is for you.”

The findings are in line with previous research, Hootman says – and it isn’t clear why the message about the benefits of walking is not influencing people’s behavior.

Dr. White says she thinks it boils down to a misconception. “The myth is, ‘My joints hurt; therefore I cannot walk.’ And what happens is people’s muscles get weak around their joints and they lose good range of motion around their joints, so walking becomes more difficult. It’s a vicious cycle. I hurt and don’t walk, therefore I get weaker and don’t have as good range of motion,” she explains. “We really would like to get a call to action to get people to realize that physical activity is helpful if done appropriately. Appropriately is low-impact, and walking is a classic example of that.”

Dr. White hopes this study will spur community advocates, state legislatures and adults with arthritis to make changes.

“When they broke down states by obesity levels, you saw some states step up and say, ‘We should do something about this.’ They started campaigns and did things in schools and passed environmental policy legislation,” Dr. White says. “It’s about trying to get people to focus, since arthritis is such a common problem and will become so much worse – going from 50 million people affected today to 67 million by 2030.”

In an effort to help patients start improving their own walking rates, the CDC is highlighting programs like the Arthritis Foundation’s evidence-based Walk With Ease program. The six-week walking program includes a guidebook and online resources to help people increase their walking to 30-minute sessions, three days a week through group classes led by certified instructors or individually at home. The program offers tips and tools including how to set safe and reasonable activity goals.

Hootman says Walk With Ease is helpful because it allows you to ease into walking and build up to 30 minutes over the six-week program. And while some people prefer doing the program themselves, the social support of a group setting is key for others to get started and keep going.

The Arthritis Foundation also has outlined environmental and policy strategies to help communities increase activity among people with arthritis by helping communities figure out how to make their local area more walkable for citizens. Click here for more information about the program.

Nationally, two-thirds of adults with arthritis say they walk fewer than 90 minutes a week (outside of routine activities) – and more than half report not walking at all during a seven-day period – despite its proven benefits, according to a new study from the Centers for Disease Control and Prevention (CDC).

California, with 42 percent, has the highest proportion of people with arthritis who report walking 90 or more minutes per week. Tennessee, with about 24 percent, has the lowest rate.

“I think the most surprising thing is that over half the people don’t do any walking in a typical week,” says lead author Jennifer M. Hootman, PhD, an epidemiologist in the Arthritis Program at the CDC’s National Center for Chronic Disease Prevention and Health Promotion. “These people are very sedentary.”

This is the first time the agency has broken down by state walking levels among adults with arthritis. The findings were published in the May 3, 2013 issue of the CDC’s Morbidity and Mortality Weekly Report.

Walking is generally recommended for people with arthritis – and it’s the type of exercise most of them prefer. Its benefits include reducing arthritis pain and fatigue, and increasing function, ability, strength and balance.

This study analyzed data from a 2011 telephone survey of nearly 154,000 people with arthritis from all 50 states, the District of Columbia and U.S. territories. Participants were asked if they had exercised or participated in physical activities in the past month, and to describe the type and frequency. Walking was the most frequent response, and was classified as any purposeful walking aside from walking for work or transportation, such as walking a dog, around the neighborhood or on a treadmill.

A total of 66 percent – and about 75 percent in eight states – reported walking less than 90 minutes or not at all per week.

These results fall far short of the 150 minutes a week of moderate-intensity exercise the CDC recommends for all Americans. The 90-minute-per-week threshold was based on the minimum amount of walking shown in one study to lower pain and improve function in people with arthritis.

“People with arthritis tell us in focus groups that walking is their preferred activity, so the fact that over 50 percent don’t walk at all is surprising. We do know people with arthritis are less active, but walking is simple and even a little bit of walking can help,” Hootman says.

She adds that walking is an ideal activity for people with arthritis because its impact on joints is low and it can be done almost anywhere for little cost. And research has shown that when done properly, walking reduces arthritis symptoms, has cardiovascular benefits and can lead to weight loss. But she acknowledges that taking the first step can still be hard.

“When we do focus groups, people say, ‘When I first started it was hard. I got sore and I kind of wanted to stop.’ But then, when they stick with it they get pain relief; they get better function.”

Patience White, MD, vice president for public health policy and advocacy at the Arthritis Foundation, says that while it’s generally understood that people don’t exercise as much as they should this state-by-state breakdown is a serious call to action.

“What they are saying is, ‘Whoa! We have a pretty significant problem in terms of people doing the most simple exercise plan.’ We aren’t asking them to go to a gym or go running. We are just asking them to walk,” says Dr. White, who is also a professor of medicine and pediatrics at George Washington University’s School of Medicine in Washington, D.C. “We’ve got a lot of work to do to let people with arthritis know how good walking is for you.”

The findings are in line with previous research, Hootman says – and it isn’t clear why the message about the benefits of walking is not influencing people’s behavior.

Dr. White says she thinks it boils down to a misconception. “The myth is, ‘My joints hurt; therefore I cannot walk.’ And what happens is people’s muscles get weak around their joints and they lose good range of motion around their joints, so walking becomes more difficult. It’s a vicious cycle. I hurt and don’t walk, therefore I get weaker and don’t have as good range of motion,” she explains. “We really would like to get a call to action to get people to realize that physical activity is helpful if done appropriately. Appropriately is low-impact, and walking is a classic example of that.”

Dr. White hopes this study will spur community advocates, state legislatures and adults with arthritis to make changes.

“When they broke down states by obesity levels, you saw some states step up and say, ‘We should do something about this.’ They started campaigns and did things in schools and passed environmental policy legislation,” Dr. White says. “It’s about trying to get people to focus, since arthritis is such a common problem and will become so much worse – going from 50 million people affected today to 67 million by 2030.”

In an effort to help patients start improving their own walking rates, the CDC is highlighting programs like the Arthritis Foundation’s evidence-based Walk With Ease program. The six-week walking program includes a guidebook and online resources to help people increase their walking to 30-minute sessions, three days a week through group classes led by certified instructors or individually at home. The program offers tips and tools including how to set safe and reasonable activity goals.

Hootman says Walk With Ease is helpful because it allows you to ease into walking and build up to 30 minutes over the six-week program. And while some people prefer doing the program themselves, the social support of a group setting is key for others to get started and keep going.

The Arthritis Foundation also has outlined environmental and policy strategies to help communities increase activity among people with arthritis by helping communities figure out how to make their local area more walkable for citizens. Click here for more information about the program.